- Molina Healthcare (Sterling Heights, MI)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (Lansing, MI)
- …largest CVS Health PBM clients. The Medicare Business Analytics - FEP - Sr . Manager provides technical, analytical and business support for the FEP Account ... team. The role serves as the authority for FEP program data analytics, trend analysis, contractual guaranteed financial metrics,...the Medicare Business Analytics - FEP - Sr . Manager incorporates these into all aspects… more
- CVS Health (Southfield, MI)
- …**Position Summary** This position is located in the state of Michigan The Sr . Compliance Manager is an experienced/career level compliance position that applies ... will work independently, as well as collaboratively, with internal senior level Medicare compliance and business teams...and DSNP products in a highly matrixed environment. The Sr . Manager Compliance maintains productive relationships and… more
- Gilead Sciences, Inc. (Detroit, MI)
- …that will improve the lives of patients with life-threatening illnesses worldwide. The ** Sr .** **Field Reimbursement Manager - HIV Prevention (** ** Sr . ... in navigating the complexities of the healthcare system. The Sr . FRM HIV Prevention will provide in-person and virtual...and reimbursement outcomes. + Assist the internal patient support program team in enhancing hub and FRM processes, such… more
- Elevance Health (Dearborn, MI)
- …Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- Stryker (Portage, MI)
- …**What you will do:** As the Senior Manager of Reimbursement and ... attending marketing/sales meetings. + Develop and maintain relationships with Medicare contractors and commercial payors (including Medical Directors, Policy… more
- Cardinal Health (Lansing, MI)
- …receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **_Responsibilities_** The Case ... Manager supports patient access to therapy through Reimbursement Support...therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is… more
- Prime Therapeutics (Lansing, MI)
- …and drives every decision we make. **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior Contract Representative is ... years of comprehensive experience working with Rebate contracts, or within Medicare /Medicaid (eg insurance, government program operations, managed care… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Manager , Revenue Integrity, the Revenue Integrity Senior Specialist has an important role in a high-profile group tasked with ... to final bill generation. Under limited supervision from the Manager , Revenue Integrity or other more senior ...and state regulations related to rules/coverage. * Knowledge of Medicare , Medicaid, Blue Cross and other third-party payers billing… more
- Henry Ford Health System (Detroit, MI)
- GENERAL SUMMARY: The Senior Retirement Consultant (SRC) is a key strategic resource for financial analysis, data integrity, budgeting and accounting information for ... math skills. The SRC often acts as a project manager ; he/she aggressively completes projects in a timely manner...the completion of benefit information on Form 990 and Medicare cost reporting. + Provides responses to IRS, PBGC… more
- Molina Healthcare (Detroit, MI)
- **Knowledge/Skills/Abilities** * Responsible for program development, implementation, and management of process improvement initiatives. * Coordinates, directs, and ... Conduct meetings and disseminates communication related to process improvement activities to senior leadership and staff as needed. * Knowledge of HEDIS measurement… more
- Gentiva (Southfield, MI)
- …difference in people's lives every day. **Overview** We're looking for a **Patient Care Manager Senior ** to join our team. You will report directly to the ... for assisting branch leadership with maintaining a high performing hospice program including managing, overseeing, and directing patient care activities to ensure… more
- CVS Health (Lansing, MI)
- …within network as well as other business areas (clinical, operations, Medicare segment). **Required Qualifications** + Successful project management experience in ... increasingly more complex projects across a highly-matrixed organization + Project/ program expertise in stakeholder facilitation, communications and relationship management… more
- Prime Therapeutics (Lansing, MI)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Clinical Program Manager - Remote **Job Description** The Clinical Program ... and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations...Structure** + Reports to Sr Principal or Sr Director in the Clinical Program Management… more
- Prime Therapeutics (Lansing, MI)
- …vision, depth perception and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the ... fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The … more
- Cardinal Health (Lansing, MI)
- …+ Pharmacy benefits management experience preferred with specific knowledge of Medicare , Medicaid and commercially insured payer common practices and policies, ... and internal customers, create and complete applications for enrollment within program timeframes, review forms and supporting documentation thoroughly for any… more
- CenterWell (Lansing, MI)
- …part of our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health ... outcomes with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the… more
- BeneLynk (Detroit, MI)
- …customers. The Business Workflow Analyst I will work in conjunction with BeneLynk's Manager of Business Analysis, Quality Assurance, the Sr . Business Analyst - ... tandem with the Manager of Business Analysis, Quality Assurance and the Sr . Business Analyst - Quality Assurance regarding QA/UAT operations as well as other… more
- Humana (Lansing, MI)
- …help us put health first** Humana's Marketing organization is seeking a Senior Business Intelligence Engineer, Measurement Strategy & Marketing Performance to join ... market trends, and campaign performance. **Key Role Functions** + Works with Campaign Manager and Campaign Strategy roles to define the measurement approach for each… more
- Molina Healthcare (MI)
- …Clinical Systems, Medical Economics, Market Engagement, etc. to ensure efficient and effective program delivery + Package material for senior leaders, up to and ... Economics and Finance teams, drive, plan and manage a comprehensive program focused on identifying, defining, designing, implementing and tracking performance for… more